Provider Demographics
NPI:1518570282
Name:THOMPSON, KAILEE GRACE (LVN)
Entity Type:Individual
Prefix:MRS
First Name:KAILEE
Middle Name:GRACE
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 COTTONWOOD LN
Mailing Address - Street 2:
Mailing Address - City:SEGUIN
Mailing Address - State:TX
Mailing Address - Zip Code:78155-0697
Mailing Address - Country:US
Mailing Address - Phone:830-433-1513
Mailing Address - Fax:
Practice Address - Street 1:201 COTTONWOOD LN
Practice Address - Street 2:
Practice Address - City:SEGUIN
Practice Address - State:TX
Practice Address - Zip Code:78155-0697
Practice Address - Country:US
Practice Address - Phone:830-433-1513
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-24
Last Update Date:2020-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX353761164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse